I’m not a vaccine expert so it’s reasonable to ask why I am confident that I want to be vaccinated for COVID-19. I will have the jab for myself, my family, friends, my work colleagues and even for people I don't know. A few reflections... #DocsForVax 1/9
First of all, I have seen first-hand too many times what COVID can do to people. It’s a truly horrible disease. It damages the lungs, the kidneys, the heart. It causes blood clots. It kills people and those who survive can take a long time to recover. #DocsForVax 2/9
As an ICU doctor, I know that every treatment I give can bring benefit or harm to my patient. I routinely balance these risks in my mind. Like all drugs, vaccines can have side-effects, but they will likely be rare compared to the harms of COVID-19. #DocsForVax 3/9
Also as an ICU doctor, I work in a multi-professional team with nurses, physios, psychologists, pharmacists, technologists, dieticians and many more in @teamaccu. I'm used to being surrounded by experts and used to trusting the advice they give me. #DocsForVax 4/9
Meanwhile, as director of R&D for @NHSBartsHealth & @QMULBartsTheLon I have seen the robust way that vaccine trials are run. I know @MHRAgovuk & @HRA_Latest are as rigorous as any drug trial regulators in the world. If they are satisfied with the safety data then I am too. 5/9
But it’s OK to ask questions. Having spent my career explaining life-threating illness to patients and their families, I understand that detailed answers can be very reassuring. When you are offered a vaccine you will have a chance to ask questions before you make a decision. 6/9
You can also do your own research, but please be very careful of mis-information on social media. Always go to a trusted source for the facts. The NHS webpages are good: nhs.uk/conditions/cor…. The @bbchealth webpages have some helpful content too. 7/9
The hardest thing I did this year was to phone a patient’s wife from his bedside in hospital to tell her that he was going to die. I stood next to him as we spoke. She never saw him again. He is just one of 70,000 heart breaking stories from 2020 in the UK. #DocsForVax 8/9
Bottom line: I trust the system I work in. I love my family and want them to be safe. I realise vaccines can have rare side-effects but the harm of COVID is everywhere. The virus will not go away on its own. It will kill people for years to come unless we stop it. #DocsForVax 9/9
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Themes of the week: vaccine roll-out, the COVID tide turning, and the lockdown ending. This is where I think we’re at, having talked again with friends across the UK and compared this all with the national data. 1/9
Friends in many (not all) badly hit hospitals tell me the second COVID tide is beginning to turn. BUT the NHS is still really busy keeping surgery services going, as well as winter pressures of acute medical admissions, and then COVID on top of all that. 2/9
News from ground level fits with the national data which show a consistent decrease in numbers of people testing positive for SARS CoV-2, a decrease in patients being admitted to hospital with COVID-19, and in subsequent deaths. 3/9
Fantastic news that the first COVID-19 vaccine has been approved for routine use so quickly. Here is why I am happy to be vaccinated and why I want my family and friends to have a vaccine too... 1/10 #InjectionforProtection#DocsforVax bbc.co.uk/news/health-55…
Widespread vaccination was always our best and only route out of the pandemic. The fewer people who carry the virus, the slower it can spread. By being vaccinated, we protect not only ourselves but our family, friends, work colleagues and so on, even strangers on the bus.... 2/10
The UK has one of the best and strictest drug regulatory processes in the world. Testing new drugs is a thing we are really good at. Anyone who has worked on a clinical trial will vouch for the rigour and safety of @MHRAgovuk and @HRA_Latest processes. 3/10
An update from ground level across the UK NHS. Things are very different to March. UK COVID-19 projections continue to look more like a ‘slow burn’ than a second wave. But the NHS is under very definite and increasing strain. We are going to have a long hard winter…… 1/12
COVID-19 hospital admissions continue to rise. Now 1750 new patients/day. Much less than the mid-April peak of 3100/day but we will reach that same rate in 8 weeks unless the rise slows. It takes at least four weeks for the lockdown to take effect. Perhaps it will soon? 2/12
The same pattern is reflected in @ICNARC (independent) data describing COVID-19 admissions to intensive care units: 140 new patients/day and rising with >1500 COVID patients currently in ICU… 3/12
Some interesting news here from @remap_cap that #Tocilizumab may improve patient outcomes for COVID-19. Understandable that the team are eager to announce this but given the limited detail and small sample of 303 patients, a few notes of caution are needed.... 1/7
The researchers have declared #Tocilizumab has 'efficacy' for a combination of patient outcomes which include survival and how long patients spend on organ support eg a ventilator. Efficacy means the drug can work in specific (usually well controlled) circumstances. 2/7
It looks like there is a big treatment effect (odds ratio: 1.87) in this trial. That's great but results like this are sometimes too good to be true. Treatment benefits are generally smaller in large trials which account for the real-world problems of delivering patient care. 3/7
As the NHS enters what will likely be our hardest ever winter, what about the Nightingales….? is a common question, and for some a retort to news that hospitals are struggling to deliver routine patient care in the face of a rapidly rising patient admissions for COVID-19. 1/10
The speed with which the Nightingale Hospitals were established, and our need to believe in them, has left us with the impression that building a major NHS hospital within a few weeks is a thing we can easily do. It isn’t. 2/10
The old Nightingale style wards had rows of beds down each wall. A few nurses could have sight of many patients, and easily communicate with each other. If a patient has a problem (e.g. cardiac arrest) it is easy to spot and help arrives faster. Photo: Wellcome Collection. 3/10
As we come to terms with a second lockdown, some reflections on the latest report on Intensive Care admissions for COVID-19 published on Friday. A big shout out to the @ICNARC team and the many ICU staff who collect the data. 1/12 icnarc.org/Our-Audit/Audi…
Patient admissions to Intensive Care with COVID-19 continue to rise steadily. The trajectory is slower than March but still enough to take us to those patient numbers by January. If we don’t stop this rise, even widespread use of temporary ICU facilities will not be enough. 2/12
As expected, ICU admissions currently reflect the heavy impact of COVID-19 on the north of England. Some ICUs are already in trouble. Thoughts with friends and colleagues doing their very best in tough circumstances. 3/12